Individual Medical Insurance (Sahatuna)

A health insurance plan that helps you deal with any sudden health adversity and high medical cost burden, Sahatuna helps you live a worry free life without compromising on your good health needs.

Features and benefits

  • Age of Entry: - 14 Days to 60 Years.
  • Citizens / Residents of Oman with Valid Visa for stay in Oman
  • Out Patient Cover
  • Cover starts after 15 days of policy issuance
  • Limit for Optional Dental and Optical cover is OMR 250 (Only with Platinum Plan)

Sahatuna- Individual Medical Insurance PolicyBronzeSilverGoldPlatinum
BenefitsInpatient and Out PatientYesYesYesYes
Optional BenefitsDental and Optical (100 Omr), Dental(65 Omr) Only, Optical Only (65 Omr)NONONOYes
Annual Limit per personOMR 3000/-OMR 3000/-OMR 5000/-
OMR 5000/-OMR 5000/-OMR 10000/-
Hospital NetworkNLGIC Designated Medical NetworkBronze NetworkBand B onlyBand A, Band B
only excluding MPH
Band A, Band B
including MPH
In-house pharmacy AccessPharmacy Access within Hospital/ ClinicNoNoYesYes
Territorial Limit- Elective TreatmentOman, India, Sri Lanka and Bangladesh onlyYesYesYesYes
Thailand OnlyNoNoYesYes
Other CountriesNoYesYesYes
Territorial limit - Emergency Treatment ##Worldwide excluding USA and CanadaYesYesYesYes
Maximum Limit per Admission or TreatmentAs per annual limitYesYesYesYes
Hospital Accommodation & ServicesCoverage for single Private RoomYesYesYesYes
Maximum no days per Admission or Treatment45 daysYesYesYesYes
ICUDirect Billing @agreed rates at
Designated Medical Provider Network
YesYesYesYes
Consultant's, Physician's,
Surgeon’s , Anaesthetist’s Fee
Direct Billing @agreed rates at Designated Medical Provider NetworkYesYesYesYes
Diagnostics (X-ray, MRI,CT Scan, Ultra Sound etc.)Direct Billing @agreed rates at Designated Medical Provider NetworkYesYesYesYes
LaboratoryDirect Billing @agreed rates at
Designated Medical Provider Network
YesYesYesYes
MedicationDirect Billing @agreed rates at
Designated Medical Provider Network
YesYesYesYes
Physiotherapy ChargesYesYesYesYes
Nursing at home for recovery and in lieu of hospital stayupto a 14 days per admission or procedureYesYesYesYes
Pre Existing / Chronic ConditionNot covered for 6
Months (Omr 250 Only)
Not Covered for 1st year, From 2nd Year 50% sum insuredNot Covered for 1st year, From 2nd Year 50% sum insuredNot Covered for 1st year, From 2nd Year 50% sum insured
Deductible / CoinsuranceFor each and every claim / visitOMR 210%10%10%
Transportation expense for
inpatient treatment abroad
Amount per person per annumRO 500RO 500RO 500RO 500
Maternity, Psychiatric
Treatment, Congenital
Hereditary and Birth Defects Treatment
Not CoveredNot CoveredNot CoveredNot Covered
Exclusions
  • Major Exclusion - All treatments within the first 15 days from the date of acceptance of the proposal by the insurer.
  • Other Exclusions for 1st Year– Hernia , Hysterectomy, Hydrocele , Piles , Surgery on joints , surgery for gastric or duodenal ulcers , Sinusitis and related Disorders , Knee Replacements due to Arthritis , Hip replacements.
  • Maternity and related expenses
  • Drug Abuse
  • Treatments arising out of racing/ hazardous activities
  • As a consequence of person under the influence of any alcoholic/narcotic or drug unless administered on the advice of a physician
  • Intentional self-injury while sane or insane.
  • War and nuclear perils.
  • Any treatment or related to HIV /AIDS
  • Congenital anomalies
  • Cosmetic treatments and routine medical examinations.

Wrong or incomplete information in application form may lead to rejection of claims or benefits.

For Complaints: complaints.om@livainsurance.com or call 90163868

For Claims: sibclaim.om@livainsurance.com or call 98883272

 

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